Unlock NBCOT Success: Essential
Musculoskeletal Study Guide.
An OTR® is working with a young adult experiencing acute lower back pain. What
INITIAL activity is most appropriate in mediation? -
\Education in basic body mechanics
An OTR® is working with a client presenting with a claw hand deformity who has both
decreased grip and lateral pinch strength. Before reading the medical notes, what type
of injury would the OTR® suspect? -
\Ulnar nerve injury
An OTR® is seeing a client 1 day post laminectomy surgery for back pain. What would
the treatment session MOST likely emphasize? -
\Instruction in log rolling and sitting and standing postures
A client with a unilateral transradial amputation is undergoing pre-positioning training for
a myoelectric arm. Which of the following is the MOST appropriate goal? -
\Within 1 week, the client will be able to accurately identify how to arrange the wrist of
the myoelectric terminal device to be able to optimally grasp different objects.
A client has a unilateral transradial amputation. The client will be fitted with a prosthetic
device in 1 month. One of the client's goals is to be independent with BADL as soon as
possible. The client refuses to use the uninvolved hand for toileting tasks, citing cultural
reasons. What INITIAL action should the OTR® take in this situation? -
\Talk with the client about using alternative strategies.
A resident in a long term care facility has a severe elbow contracture. The OTR® has
just finished applying a bivalved splint to provide low load prolonged stress to the
affected elbow. What MUST the OTR® do as part of the care plan for maximizing the
effectiveness of this splinting intervention? -
\Provide nursing staff with specific instructions for a graded daily splint-wearing
schedule.
An OTR® is preparing to discharge a client to home after hip replacement. The client
reports having a high-step tub with a shower door and no money to buy additional
equipment. Which recommendation is MOST appropriate for bathing? -
\Recommend the client sponge-bathe at the sink until equipment can be purchased
An OTR® needs to choose an assessment for a client experiencing fibromyalgia that
provides information on the client's sleep patterns, level of fatigue, cognition, and mood
changes. Which assessment can BEST provide this information? -
\Daily activity log
,For which condition is a custom wheelchair seating system MOST appropriate? -
\Multiple sclerosis (MS)
A client had surgery 6 weeks ago. The surgeon used a plate to fix a metacarpal shaft
fracture. The client is experiencing moderate edema that makes it difficult to make a fist.
Grasping containers and manipulating clothing fasteners are the most difficult tasks.
What is the BEST approach for the OTR® to take to address the client's edema? -
\Cold packs and compression glove
According to the Americans With Disabilities Act of 1990 (ADA), what is the definition of
essential job functions when considering employment of a person with a disability? -
\Functions that an employee must be able to complete, with or without a reasonable
accommodation
An OTR® is working with a client 8 weeks after a unilateral traumatic transtibial
amputation. The client's residual limb is well healed, and the team has identified
prosthetic fitting and training as the next step. The client wants to use a prosthesis but
indicates that the residual limb is not healed enough and is fearful about wearing it. The
client's mother currently performs all limb care, including washing, dressing, and
wrapping. What is the BEST strategy to progress the client to prosthetic training? -
\Have the client talk with other clients who have similar amputations.
An inpatient who has Stage III lung cancer undergoes surgery for removal of axillary
lymph nodes of the dominant upper extremity, followed by palliative chemotherapy. The
patient is referred to occupational therapy for ROM, edema management, and
preparation for hospice care at home. What information about the patient MUST the
OTR® obtain prior to initiating intervention? -
\Postsurgical precautions and mobility limitations
What advantage does using a functional motion assessment provide an OTR® when
evaluating a client? -
\The OTR can assess range of motion (ROM), strength, and motor control in a natural
environment.
In a functional motion assessment, an OTR observes a client during functional tasks to
assess ROM, strength, and motor control in a natural environment. The OTR can also
observe cognitive function, awareness, and sensory deficits.
An OTR® is working with a client who has had a cerebrovascular accident (CVA). One
of the client's goals is independence in baking activities. Which modality intervention is
BEST used to decrease shoulder subluxation of the nonpainful hemiparetic arm during
this task? -
\Neuromuscular electrical stimulation (NMES)
, A client who has rheumatoid arthritis (RA) has difficulty with ADL tasks and has been
referred to occupational therapy. Which statement reflects a principle of joint protection?
-
\The client should use an alternate grip on a walker, to provide more stability during
ambulation.
An OTR® is working with a client who was recently diagnosed with de Quervain
syndrome. In addition to the medical treatment of corticosteroid injection, what
nonoperative treatment is MOST appropriate for this condition? -
\Forearm-based thumb spica splint
An OTR® is preparing to discharge a client who recently underwent hip surgery. The
client is planning to ride home in a very small car with bucket seats. What is the BEST
recommendation for the client's circumstances? -
\Suggest an arrangement for alternative transportation to limit stress on the hip.
An OTR® is working with a client with newly diagnosed osteoporosis. The client's
insurance will only cover one community evaluation. Which of the following would be the
MOST important environmental evaluation to complete? -
\An evaluation of the home for fall risk
An OTR® decides to use desensitization techniques in structured practice within the
context of daily activities for a client with hypersensitivity secondary to peripheral nerve
injury. Which desensitization technique would be the MOST therapeutic initially? -
\Instruct the client in use of a transcutaneous electrical nerve stimulation (TENS) unit
during desensitization activities
An OTR® is working with a client who has just had a total hip replacement using an
anterolateral approach. Which type of equipment is MOST important for maintaining
appropriate hip precautions? -
\An abductor wedge
Hip precautions for an anterolateral approach are no external rotation, no adduction
(crossing legs or feet), and no hip extension. An abductor wedge will prevent external
rotation and adduction of the hips.
An OTR® is performing a presurgical intervention with a client who will undergo hip
replacement surgery in a few days. Which recommendation regarding sleep positioning
is MOST appropriate? -
\The client should sleep in supine position with a wedge or pillow in place.
An OTR® works in a clinic for clients with low back pain. What is the BEST way for the
OTR® to evaluate the client's spinal postures? -
\Observe the client performing ADLs, IADLs, and work-related tasks
Musculoskeletal Study Guide.
An OTR® is working with a young adult experiencing acute lower back pain. What
INITIAL activity is most appropriate in mediation? -
\Education in basic body mechanics
An OTR® is working with a client presenting with a claw hand deformity who has both
decreased grip and lateral pinch strength. Before reading the medical notes, what type
of injury would the OTR® suspect? -
\Ulnar nerve injury
An OTR® is seeing a client 1 day post laminectomy surgery for back pain. What would
the treatment session MOST likely emphasize? -
\Instruction in log rolling and sitting and standing postures
A client with a unilateral transradial amputation is undergoing pre-positioning training for
a myoelectric arm. Which of the following is the MOST appropriate goal? -
\Within 1 week, the client will be able to accurately identify how to arrange the wrist of
the myoelectric terminal device to be able to optimally grasp different objects.
A client has a unilateral transradial amputation. The client will be fitted with a prosthetic
device in 1 month. One of the client's goals is to be independent with BADL as soon as
possible. The client refuses to use the uninvolved hand for toileting tasks, citing cultural
reasons. What INITIAL action should the OTR® take in this situation? -
\Talk with the client about using alternative strategies.
A resident in a long term care facility has a severe elbow contracture. The OTR® has
just finished applying a bivalved splint to provide low load prolonged stress to the
affected elbow. What MUST the OTR® do as part of the care plan for maximizing the
effectiveness of this splinting intervention? -
\Provide nursing staff with specific instructions for a graded daily splint-wearing
schedule.
An OTR® is preparing to discharge a client to home after hip replacement. The client
reports having a high-step tub with a shower door and no money to buy additional
equipment. Which recommendation is MOST appropriate for bathing? -
\Recommend the client sponge-bathe at the sink until equipment can be purchased
An OTR® needs to choose an assessment for a client experiencing fibromyalgia that
provides information on the client's sleep patterns, level of fatigue, cognition, and mood
changes. Which assessment can BEST provide this information? -
\Daily activity log
,For which condition is a custom wheelchair seating system MOST appropriate? -
\Multiple sclerosis (MS)
A client had surgery 6 weeks ago. The surgeon used a plate to fix a metacarpal shaft
fracture. The client is experiencing moderate edema that makes it difficult to make a fist.
Grasping containers and manipulating clothing fasteners are the most difficult tasks.
What is the BEST approach for the OTR® to take to address the client's edema? -
\Cold packs and compression glove
According to the Americans With Disabilities Act of 1990 (ADA), what is the definition of
essential job functions when considering employment of a person with a disability? -
\Functions that an employee must be able to complete, with or without a reasonable
accommodation
An OTR® is working with a client 8 weeks after a unilateral traumatic transtibial
amputation. The client's residual limb is well healed, and the team has identified
prosthetic fitting and training as the next step. The client wants to use a prosthesis but
indicates that the residual limb is not healed enough and is fearful about wearing it. The
client's mother currently performs all limb care, including washing, dressing, and
wrapping. What is the BEST strategy to progress the client to prosthetic training? -
\Have the client talk with other clients who have similar amputations.
An inpatient who has Stage III lung cancer undergoes surgery for removal of axillary
lymph nodes of the dominant upper extremity, followed by palliative chemotherapy. The
patient is referred to occupational therapy for ROM, edema management, and
preparation for hospice care at home. What information about the patient MUST the
OTR® obtain prior to initiating intervention? -
\Postsurgical precautions and mobility limitations
What advantage does using a functional motion assessment provide an OTR® when
evaluating a client? -
\The OTR can assess range of motion (ROM), strength, and motor control in a natural
environment.
In a functional motion assessment, an OTR observes a client during functional tasks to
assess ROM, strength, and motor control in a natural environment. The OTR can also
observe cognitive function, awareness, and sensory deficits.
An OTR® is working with a client who has had a cerebrovascular accident (CVA). One
of the client's goals is independence in baking activities. Which modality intervention is
BEST used to decrease shoulder subluxation of the nonpainful hemiparetic arm during
this task? -
\Neuromuscular electrical stimulation (NMES)
, A client who has rheumatoid arthritis (RA) has difficulty with ADL tasks and has been
referred to occupational therapy. Which statement reflects a principle of joint protection?
-
\The client should use an alternate grip on a walker, to provide more stability during
ambulation.
An OTR® is working with a client who was recently diagnosed with de Quervain
syndrome. In addition to the medical treatment of corticosteroid injection, what
nonoperative treatment is MOST appropriate for this condition? -
\Forearm-based thumb spica splint
An OTR® is preparing to discharge a client who recently underwent hip surgery. The
client is planning to ride home in a very small car with bucket seats. What is the BEST
recommendation for the client's circumstances? -
\Suggest an arrangement for alternative transportation to limit stress on the hip.
An OTR® is working with a client with newly diagnosed osteoporosis. The client's
insurance will only cover one community evaluation. Which of the following would be the
MOST important environmental evaluation to complete? -
\An evaluation of the home for fall risk
An OTR® decides to use desensitization techniques in structured practice within the
context of daily activities for a client with hypersensitivity secondary to peripheral nerve
injury. Which desensitization technique would be the MOST therapeutic initially? -
\Instruct the client in use of a transcutaneous electrical nerve stimulation (TENS) unit
during desensitization activities
An OTR® is working with a client who has just had a total hip replacement using an
anterolateral approach. Which type of equipment is MOST important for maintaining
appropriate hip precautions? -
\An abductor wedge
Hip precautions for an anterolateral approach are no external rotation, no adduction
(crossing legs or feet), and no hip extension. An abductor wedge will prevent external
rotation and adduction of the hips.
An OTR® is performing a presurgical intervention with a client who will undergo hip
replacement surgery in a few days. Which recommendation regarding sleep positioning
is MOST appropriate? -
\The client should sleep in supine position with a wedge or pillow in place.
An OTR® works in a clinic for clients with low back pain. What is the BEST way for the
OTR® to evaluate the client's spinal postures? -
\Observe the client performing ADLs, IADLs, and work-related tasks
